Leptomeningeal Carcinomatosis in a Krukenberg Tumor Associated with Signet Ring Cell Gastric Cancer
Bilgin Bahadır BAŞGÖZ, 1 Birol YILDIZ,2 Adem AYDIN, 1 Gökhan ERDEM,2 Harun ASLAN, 1 Kenan SAĞLAM, 1 Fikret ARPACI2
1Department of Internal Medicine, Gülhane Training and Research Hospital, Ankara-Turkey
2Department Medical Oncology, Gülhane Training and Research Hospital, Ankara-Turkey
Leptomeningeal carcinomatosis (LCM) is a rare complication of gastric cancer. It usually occurs late in advanced stage of disease and is sometimes misdiagnosed as toxicity of chemotherapeutic agents. Here we report a rare case of gastric cancer that developed LCM in follow-up. A 28-year-old woman with signet ring cell gastric cancer associated with Krukenberg tumor was admitted with persistent headache, nausea, vomiting, vertigo, and diplopia. Linear appearance of contrast enhancement in cerebellar fissures and around cranial nerves was seen in magnetic resonance imaging and cerebrospinal fluid was hypercellular with numerous carcinoma cells. LMC was confirmed and treated with intrathecal methotrexate and additional whole-brain irradiation. LCM is a rare complication, but occurs more often than expected and is often misdiagnosed. If patient who is being treated for gastric cancer presents with neurological symptoms, LCM should be kept in mind. Clinical improvement can be achieved with current treatment modalities, including radiotherapy, chemotherapy, or targeted molecules. Keywords : Gastric cancer; Krukenberg tumor; leptomeningeal carcinomatosis; signet ring cell